Search results for "030503 health policy & services"
showing 10 items of 207 documents
Predicting intention to participate in self-management behaviors in patients with Familial Hypercholesterolemia: A cross-national study
2019
Abstract Rationale Familial Hypercholesterolemia (FH) is a genetic condition that predisposes patients to substantially increased risk of early-onset atherosclerotic cardiovascular disease. FH risks can be minimized through regular participation in three self-management. Behaviors physical activity, healthy eating, and taking cholesterol lowering medication. Objective The present study tested the effectiveness of an integrated social cognition model in predicting intention to participate in the self-management behaviors in FH patients from seven countries. Method Consecutive patients in FH clinics from Australia, Hong Kong, Brazil, Malaysia, Taiwan, China, and UK (total N = 726) completed m…
Recommendations for design and analysis of health examination surveys under selective non-participation
2019
Background The decreasing participation rates and selective non-participation peril the representativeness of health examination surveys (HESs). Methods Finnish HESs conducted in 1972–2012 are used to demonstrate that survey participation rates can be enhanced with well-planned recruitment procedures and auxiliary information about survey non-participants can be used to reduce selection bias. Results Experiments incorporated to pilot surveys and experience from previously conducted surveys lead to practical improvements. For example, SMS reminders were taken as a routine procedure to the Finnish HESs after testing their effect on a pilot study and finding them as a cost-effective way to inc…
Evaluation design of Urban Health Centres Europe (UHCE): preventive integrated health and social care for communitydwelling older persons in five Eur…
2017
BackgroundOlder persons often have interacting physical and social problems and complex care needs. An integrated care approach in the local context with collaborations between community-, social-, and health-focused organisations can contribute to the promotion of independent living and quality of life. In the Urban Health Centres Europe (UHCE) project, five European cities (Greater Manchester, United Kingdom; Pallini (in Greater Athens Area), Greece; Rijeka, Croatia; Rotterdam, the Netherlands; and Valencia, Spain) develop and implement a care template that integrates health and social care and includes a preventive approach. The UHCE project includes an effect and process evaluation.Meth…
Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study
2019
Background Medication errors are a serious and complex problem in clinical practice, especially in intensive care units whose patients can suffer potentially very serious consequences because of the critical nature of their diseases and the pharmacotherapy programs implemented in these patients. The origins of these errors discussed in the literature are wide-ranging, although far-reaching variables are of particular special interest to those involved in training nurses. The main objective of this research was to study if the level of knowledge that critical-care nurses have about the use and administration of medications is related to the most common medication errors. Methods This was a m…
Patient-centred access to health care: a framework analysis of the care interface for frail older adults
2018
Abstract Background The objective of this study was to explore the issues surrounding access to health and social care services for frail older adults with Polish stakeholders, including healthy and frail/pre-frail older adults, health care providers, social care providers, and caregivers, in order to determine their views and perspectives on the current system and to present suggestions for the future development of a more accessible and person-centred health and social care system. Methods Focus groups were used to gather qualitative data from stakeholders. Data were analysed using framework analysis according to five dimensions of accessibility to care: approachability, acceptability, av…
Socioeconomic inequality in non-communicable diseases in Europe between 2004 and 2015: evidence from the SHARE survey
2018
Background The scope of this work was to investigate socioeconomic inequalities among European adults aged 50 or older in chronic diseases and behavioural risk factors for these diseases, namely, smoking habits, obesity and physical inactivity, between 2004 and 2015. Methods Data for this study were drawn from the Survey of Health, Ageing and Retirement (SHARE) in Europe, which is a panel database of microdata on health, socioeconomic status and social and family networks of people aged 50 years or older, covering most of the European Union. The predicted number of non-communicable diseases (NCDs) was used to estimate the concentration index and to find the contributions of determinants to …
Smoking and long-term labour market outcomes.
2014
Objective To examine the long-term effects of smoking on labour market outcomes using twin data matched to register-based individual information on earnings. Method Twin data for Finnish men born 1945–1957 was used to remove the shared environmental and genetic factors. The results were subjected to extensive robustness testing. Lifetime cigarette consumption was measured by (cumulative) cigarette pack-years in early adulthood. The average of an individual's earnings (and, alternatively, taxable income) was measured over a subsequent 15-year period in later adulthood. Results Smokers have lower long-term income and earnings. For example, controlling for the shared environmental and genetic …
Predictors of emergency department referral in patients using out-of-hours primary care services
2016
Background Out of hours (OOH) doctors could manage many cases limiting the inappropriate accesses to ED. However the possible determinants of referral to ED by OOH doctors are poorly studied. We aimed to characterize patients referred from the OOH to ED service in order to explore the gate-keeping role of OOH service for hospital emergency care and to facilitate future research in improving its cost-effectiveness. Methods A retrospective study was made through data collection of 5217 contacts in a local OOH service in the North-East of Italy (from 10/01/2012 to 03/31/2013). Results Only 8.7% (=454 people) of the total contacts were referred to ED. In the multivariate analysis, the significa…
The unobserved pattern of material hardship and health among older Americans
2019
This paper investigates the relationship between self-reported health and material hardship among older Americans. Differently from income-based measures, material hardship provides a more specific description of the concrete adversities faced by the elderly. We have used the last six waves of the Health and Retirement Study to explore the relative contributions of state dependence, unobserved heterogeneity and time-specific shocks on reporting poor health, experiencing food insecurity and medication cutbacks. We have used a Latent Markov model to estimate a multivariate non-linear system of equations for panel data allowing time-varying unobserved heterogeneity. Our results reveal a high s…
Predictors of clinical events occurring during hospital stay among elderly patients admitted to medical wards in Italy.
2016
Abstract Background Clinical events occurring during hospital stay are independent predictors of prolonged hospitalization, in-hospital mortality and readmission among elderly patients admitted to medical wards. Purpose To identify predictors of intercurrent clinical events (ICE) during hospital stay among the main demographic, functional and clinical characteristics assessed at hospital admission in a multicenter sample of elderly inpatients in Italy. Methods This observational prospective cohort study was conducted in 66 internal and geriatric medicine hospital wards in 2010. It enrolled 1267 inpatients aged 65 years or older living at home before hospitalization. Multivariable Poisson re…